Acromegaly - Gigantism; The World's Tallest Human
Endocrine System Disorder
The pituitary gland is often referred to as the "master gland" because it secretes hormones that control hormone secretion of other endocrine glands. acromegagly or gigantism is a disorder of the pituitary gland. It is most often the result of a benign slow-growing tumor that secretes growth hormones. Acromegaly and Gigantism is the exact same thing, the disease is called gigantism if it occurs during childhood when long bones are still growing, because it causes a person to grow in height, acromegaly occurs after the closure of the long bones.
Hyperpituitarism is a pathologic state caused by excess production of growth hormone. Causing gigantism/acromegaly …Gigantism, a disease of the pituitary , occurs early on in childhood or during puberty while the long bones of the body are still growing. Excessive action of Insulin-like growth takes place often because of a macro adenoma on the pituitary. The growth of these bones is usually proportional and may cause affected people to reach heights of up to eight feet and weights of over 300 pounds. These patients tend to develop multiple health problems and die in early adulthood.
Complications of Gigantism
The most frequent causes of death of those with gigantism are cardiovascular, respiratory and osteoarthritis complications. There is disagreement on whether malignancy is a significant cause of increased mortality. A tumor is thought to put pressure on the pituitary and the presence of that tumor causes excess growth hormone to be secreted. Surgery is done to remove the tumor and patients can lead a normal life with normal life expectancy. If the tumor does not have clearly defined borders; and other situations in which surgery cannot completely remove the tumor, medication is the treatment of choice. The most effective medications are somatostatin analogs (such as octreotide or long-acting lanreotide), which reduce growth hormone release. Dopamine agonists radiation therapy has also been used to bring growth hormone levels to normal. However, it can take 5-10 years for the full effects to be seen and almost always leads to low levels of other pituitary hormones. Radiation therapy has been linked to learning disabilities and emotional changes in children and most experts recommend it only when surgery fails.
Complicatioms of Acromegaly
Acromegaly occurs in the fourth or fifth decade of life and because ephyseal closure (long Bone closure) has already taken place, there is no longitudinal growth. Instead, bones increase in thickness and width. Because of its rarity , and slow progression, it is not easily diagnosed. Some symptoms are headache and visual deficits due to pressure on the optic nerves. It often goes many years without being treated. Most patients are diagnosed after they have developed physical changes. Severe disfigurement can take place with distinct characteristics. Such as enlarged hands, feet, jaw and brow bone. In addition to soft tissues may become enlarged. Such as skin and tongue. Acromegaly also affects the cardiovascular, digestive, nervous and genitourinary systems.
Acromegaly is based on a number of data sources, including physical assessment. That should include height and weight , vital signs and contours of the face and skull, visual acuity , speech and voice quality. Medical treatments are surgery, However, the skeletal changes and disfigurement can not be reversed. And drug therapy, such as dopamine agonists which can reverse or improve tissue hypertrophy. And finally, GH receptor antagonists- Octreotide. Because this drug also suppresses insulin secretion, Patient’s blood glucose must be monitored. Education and emotional support are vital components in the nursing care of the patient with Acromegaly. Patients presenting with this disease need to know that many body changes, such as visual disturbances and visceral enlargement, are not reversible. Surgical treatment is aimed primarily at preventing further symptoms and complications.
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